Neurocognitive Benefits of Physiotherapy for Spinal Cord Injury

Spinal cord injury (SCI) interrupts the brain-body input-output exchange and modifies the mental representation of disconnected body parts, with decreased reliance on sensorimotor aspects of body representation and increased weighting of visuospatial ones. We hypothesized that physiotherapy-related benefits might extend to the re-establishment of the typical interplay between these two types of strategies. To test this hypothesis, we asked 42 participants (21 individuals with SCI pre- and post-physiotherapy, plus 21 controls) to perform mental rotation of corporal images (a cognitive task than can activate one or the other strategy). Results showed that only after physiotherapy the individuals with SCI showed the sensorimotor biomechanical effect (orientation-dependent modulation of response times) for the mental rotation of foot images (absent in pre-physiotherapy). This highlights that body representation is adaptable to contingent conditions, in that the reliance on sensorimotor or visuospatial strategies can be altered and, at least partially, restored as a function of physiotherapy.